Millis R M, Young R C, Kulczycki L L
Chest. 1977 Apr;71(4):508-13. doi: 10.1378/chest.71.4.508.
Validation of rigid-tube bronchoscopy with small-volume (5-ml increments not to exceed 300 ml) bronchial washing as a therapeutic adjunct was performed on six patients with cystic fibrosis, using serial tests of pulmonary function as a yardstick for assessment of efficacy. Two patients did not undergo the procedure and served as control subjects. All patients were characterized as having varying severity of pulmonary involvement. Large central airways were severely obstructed, and older patients had more trapped gas in their lungs. Hypoxemia and large alveolar-arterial oxygen pressure differences [P(A-a)O2] were due to inhomogeneity of alveolar ventilation. Results indicated that up to ten days to two weeks, bronchoscopic bronchial washing may in some instances improve maximal expiratory flow-volume curves and specific airway conductance and decrease P(A-a)O2 towards normal. Distribution of alveolar gas P(A-a)O2 towards normal. Distribution of alveolar gas became more homogeneous. We conclude that bronchoscopic bronchial washing may be effective in the management of patients with cystic fibrosis, by augmentation of their inadequate cleansing function of the conducting airways.
对6例囊性纤维化患者进行了硬管支气管镜检查并联合小容量（每次增加5毫升，不超过300毫升）支气管灌洗作为一种治疗辅助手段，以肺功能的系列检查作为评估疗效的标准。2例患者未接受该操作，作为对照。所有患者均表现为肺部受累程度不同。大的中央气道严重阻塞，老年患者肺部有更多的气体潴留。低氧血症和较大的肺泡-动脉氧分压差[P（A-a）O2]是由于肺泡通气不均匀所致。结果表明，在长达10天至2周的时间里，支气管镜下支气管灌洗在某些情况下可改善最大呼气流量-容积曲线和比气道传导率，并使P（A-a）O2降低至正常。肺泡气体分布向正常转变，肺泡气体分布变得更加均匀。我们得出结论，支气管镜下支气管灌洗通过增强传导气道清洁功能不足，可能对囊性纤维化患者的治疗有效。
